Individual
MRS. ANTOINETTE MATYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6725 188TH ST, FRESH MEADOWS, NY 11365-3767
(718) 454-6460
Mailing address
6725 188TH ST, FRESH MEADOWS, NY 11365-3767
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
706826131
NY
174400000X
Specialist
Primary
706826131
NY
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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